BACKGROUND: We assessed the results of therapy for advanced lymph node metastases (N3) and its relation with the prognosis of squamous cell carcinoma of the head and neck. METHODS: Files of 241 patients with squamous cell carcinoma of the mouth, oropharynx, larynx and hipopharynx with advanced metastatic lymph nodes (N3), submited to surgery and/or radiotherapy, were reviewed at the Head and Neck and Otorhinolaryngology Department of Hospital Heliópolis, Hosphel, São Paulo (1988 to 1998). For the surgical group, complete or incomplete resection was evaluated and for the irradiated group the responsiveness at the end of the therapy was analysed. Disease- free survival for the first group was evaluated using Kaplan-Meier. RESULTS: The unresecability of the neoplasia justified the radiotherapy at medium dose of 65 Gy for 69 patients, with complete response at primary lesion in 24(36%), and at the neck in 12(18%), and for both sites in 11(16%). For the surgical group followed by irradiation, the medium dose was 56 Gy. From 25 patients submitted to radical resection of the neck, five (20%) presented recurrence, and the five cases with partial resection and radiotherapy, two presented a global survival from seven to 12 mouths. For the surgical group, disease-free survival for two years was 58%. CONCLUSIONS: For patients with N3 neck node metastases, neck dissection, followed by radiotherapy, was effective for disease regional control, while, for inoperable cases, radiotherapy was only a paliative method.
Lymph Node; Neoplasm metastasis; Carcinoma, squamous cell; Head and Neck neoplasms; Prognosis
